running around too much lately?

Do you or do you not treat a non self limiting minor illness?

He came in asking for terbinafine once-only formulation. Terbinafine commonly used to treat athlete’s foot and the formulation he asked for is to be applied only once and it will leave a film which then releases terbinafine for up to 13 days. It costs more compared to the cream formulation which is to be applied once daily for up to 14 days and the public generally are not aware of the once formulation while others are skeptical towards it, most, however are put off by the cost.

I decided to spend more time with him as it was not that busy in the pharmacy. After confirming the classic symptoms of athlete’s foot with him, further questioning revealed that the most recent episode of athlete’s foot is a recurrent infection, not too surprising considering he is fairly familiar with the range of terbinafine available.

He does not resist much of my counselling so I took him through on some general points on self care before taking it a step further recommending pine tar gel to help with the inflammation and itch, to be used before applying the terbinafine. I glanced at his feet and he was wearing leather shoes. A chance to push the sales with miconazole powders I thought, might as well eradicate any possible chance of reinfection this time.

As he was getting more comfortable with me, he enquired about the amorolfine used to treat fungal infections of the nails, big toe and one small toe of his was infected. The reason he kept getting reinfected was identified at last. Amorolfine is only available as a kit and he complained about the product being pricey despite the kit should last him six to nine months depending on the severity of his nails infection. The longer he left it untreated, the more time and money he had to spend treating it in the end assuming the infection do not spread to the nail bed.

While the majority of untreated athlete’s foot proceeds to infect the nails sooner or later, this very customer keeps getting recurrent episodes of athlete’s foot because he left the nails infection untreated.

You just have to live with surprises working in a retail pharmacy, not the kind of surprises you want though.